It can happen on every age and has no age boundaries. Someone with a PTSD can suffer a Partial or Full dissociation. Which means he or she can’t recall | remember the traumatic or a part of the traumatic event.

We all ownone Personality which is given color by our Self states¹ and Ego states².To the understanding of, suffering a psychologically-Trauma:all traumatic events (psychologically and mechanically) can cause Dissociative Behavior | psychologically-Trauma
and all mental disorders caused by psychologically-Trauma hold Dissociative symptoms

Let us take a closer look at our main personality-states which handle every day life, the self-states and the ego-states;

The Self-States (SD ANP parts)
are parts of our personality which function fully autonomic and are daily life task oriented.
These parts of our personality own their own consciousness and self-awareness.Examples of Self-states are:
You need to clean the house and you instinctively know what to do and how to do it. You know how the vacuum cleaner works or what you have to use to clean the windows etc. To every little task you remember what is needed or what to do at that moment: like cooking, doing your finances, call your friend at his/her birthday, etc.. those are all different self-states (SS’s) which we call smaller Apparently Normal Personality parts of the total personality ANP-EP(’s) handling system.Note:If a person suffers a PTSD or CPTSD or a Dissociative Disorder like OSDD
The self-states we call smaller ANP ‘parts’ which belong to the total personality (1 ANP-EP handling system).
Those Self-state parts¹ (ANP parts) are vulnerable to the influence of Ego-States² and or EP parts³

Beside the Self-States we all also own Ego-states
which influences also our Self-Sates…

Ego States
are personality states which react emotion oriented. They respond to emotional daily live needs or events and provide us with normal and healthy reactions which color our own personality.
But… they also can develop a pathologically behavior such as Borderline-, Narcissistic personality disorder, pathological sociopathic- or psychopathic behavior, etc. – and otherwise described dissociative disorders including switching behavior to other personality states (not DID).Examples of Ego States are:
The need for attention, or personal comfort, or the need to be someone (to be recognized), the need to feel proud of what you do or did, the need of being loved or to give love to another person, the need for sex or erotic responses, the need to express your anger or sadness etc. Al those needs are normal human emotions (feelings) which we all carry inside of us. And we also carry all biologically given narcissistic genes or psychopathically genes (we are all able to get triggered to unthinkably or unhealthy behavior). It’s human nature.Note:Pathologically (damaged, sick, unhealthy, etc.) Ego-States can cause switching behavior, because they are very vulnerable to the influences of pathologically genes and or biologically given vulnerability. But they also can be controlled or influenced by traumatized EP parts such as most commonly seen within OSDD. Traumatizing experiences and or Childhood neglect can contribute to development of a Borderline Personality Disorder + Dissociative symptomps. Those pathologically Dissociative Ego-States can express itself also by switching behavior to different personality states. That is also the reason why so many people get wrongly diagnosed with a dissociative Identity disorder and the other way around, or misdiagnose with another mental disorder such as Schizophrenia.

PTSD and complex-PTSD (including Dissociative Disorders)

If we get Psychologically-Traumatize we develop pathologically personality parts which hold memories of a traumatic experience. Those parts we call:

Dissociated Emotional Personality Parts (EP’s)

A traumatized personality part(s) !!Like the Self-states those EP’s own their own consciousness and self-awarenessWithin the structural dissociation of the personality we call those parts EP’s which cause dissociative behavior. These psychologically traumatized parts of the personality hold a total memory of a traumatic event or a part of a traumatic event – physical and emotional memories which belong to the past.Those parts can be:
1. totally dissociated by the personality (full dissociation)
2. partly dissociated by the personality (partial dissociation)
Examples of EP’s are:
Someone who experienced a very severe accident on a particular crossroad, can start to avoid that particular crossroad, or even worse: don’t go nearby a crossroad again. And this (phobic) fear exists without realizing or thinking over the full memory (EP) which caused her/him to develop this pathologically behavior towards crossroads.
Or someone who experienced severe traumatic events during a war can develop irritated and avoidant behavior towards lots of things in the present time without realizing his behavior is being influenced by the traumatic events he/she experienced during war and which didn’t process in to his own personality sate – the EP’s got stuck in the past. He/she avoids thinking on those traumatic events and develops irritated and or defensive, aggressive behavior under the influence of the EP’s.Note:If an Self-State or Ego-State gets triggered by ‘recognition’ – by a particular daily life subject or event – the EP that got triggerd by that recognition influences the behavior of the Self-state and Ego-State. On such a moment the ANP-EP system – which we call a handling system – gets in to pathologically behavior (not healthy behavior). The biologically stability of the whole personality will also play a very big role towards ‘how this behavior will express itself’ (including switching behavior to different personality states). But the cause of that particular behavior on such a moment gets triggered and influenced by an EP.

Personality and Identity:Above we gave a summary of a normal to a pathologically Personality and the different personality states. Everything above can develop itself without suffering a DID. The expression of the total of our personality-states plus our biologically (determinants) and biographically presentation will give form to our own Identity.

The Dissociative Identity Disorder

All traumatic events can cause Dissociative Behavior e.g. Psychologically-Trauma as we explained already above. So again what is the difference between a primary and secondary Structural dissociation (PTSD CPTSD OSDD) and the Tertiary Structural dissociation (DID)?

Note of importance: One can suffer a Dissociative Identity Disorder (DID)without suffering a Personality Disorder !
Borderline is a symptom diagnose and can develop itself during all ages of childhood, likewise a structural dissociation of the personality OSDD or PTSD.

DID though is another story:
DID Research has shown us that the development of a DID starts during the very early stage of life.

Hypothetically to the explanation of “why could such a very young child develop more than one ‘handling system’”;
We are all born with biological determinants and four autonomic emotional handling/respond systems (the 4 head emotions). Emotional handling systems which immediately after birth are able to react by instinct or reflex. If a baby feels distress caused by hunger it starts to cry. If you have eye contact with a baby which has already its vision and you slap your hands the baby gets scared (you will see the reflex) caused by the loud noise even though its sees you slapping your hands, etc.. The baby is not yet able to mentalize hearing with vision, it’s not yet enough developed to do so (recognition). The emotionally systems pleasure/fun and fear are not yet enough integrated to function as proper team players.
If something disrupted this proses (like repeating Trauma – see part I pnt 1) an infant needs to activate by instinct repeatedly a (survival) reflex which causes that the autonomic functioning emotions can’t synthesize prober with one and other on a natural given way to learn prober functioning as team players. This can lead to the development of a DID cause by Trauma.

A tertiary structural dissociation of the personality
Someone who suffers a Dissociative Identity Disorder developed in a very early stage of life two and sometimes even three of those ANP-EP’s handling systems. Each of those handling systems own their own distinct behavior, knowledge and memories. This causes also a lack of recognition of one’s own autobiographically memories. The switching between those ANP-EP’s systems can occur very subtle but also very recognizable if you know the total personality for a longer time. DID is a poly-symptomatic condition which is characterized by a hidden presentation.

In case of a Dissociative Identity Disorder the ANP’s (self-states) also function task oriented within each main ANP-EP’s handling.
But beside that the main ANP-EP’s handling systems functions also head emotion oriented.
So here we also need to have knowledge about the four head emotion of humanity which within DID form the base to develop a pathologically survival mechanism such as a Dissociative Identity Disorder is.

1

The 4 head emotions
of every human being

Joy, (Pleasure, laughter, sex, etc.)

2

Fear (defense, Freeze, etc.)

3

Anger (defense, physical attack, etc.)

4

Sadness (tears, loneliness, mourning, etc.)

**

People who suffer a DID have developed two or even (very rare) 3 ANP-EP handling systems which are not only task orientated but also act head emotion orientated. ANP-EP systems behave Apparently Normal – and carry an own distinct, stable over time and growth, identifiable behavior. An identity disorder caused by psychologically-Trauma

ICD-11 PTSD & Complex PTSD

There has long been debate about whether Complex Posttraumatic Stress Disorder (Complex PTSD) is distinct from Borderline Personality Disorder (BPD) comorbid with PTSD. Part of the difficulty in this evaluation has been the lack of clear and consistent characterization of Complex PTSD. The World Health Organization (WHO) Working Group on the Classification of Stress-Related Disorders has proposed the inclusion of Complex PTSD as a new diagnosis related to but separate from PTSD (Maercker et al., 2013). Both of these disorders are viewed as distinct and separate from BPD. An emerging and accumulating empirical literature is demonstrating consistent and clear differences between ICD-11 PTSD and Complex PTSD. In addition, it is important to determine the construct validity of Complex PTSD as empirically distinct from BPD particularly among those with a trauma history. This investigation evaluated whether ICD-11 Complex PTSD could be distinguished from DSM-IV BPD in a treatment-seeking population of women with childhood abuse.
The WHO proposed that the development of ICD-11 be guided by the principle of clinical utility. Characteristics of clinical utility include the organization of disorders that are consistent with clinicians’ mental health taxonomies, that contain a limited number of symptoms so that they can be easily recalled and used in the field, and that are based on distinctions important for management and treatment (Reed, 2010). The distinction between ICD-11 PTSD and Complex PTSD are consistent with these guidelines (see Cloitre, Garvert, Brewin, Bryant, & Maercker, 2013; Maercker et al., 2013). For example, ICD-11 PTSD is construed as a fear-based disorder and symptoms are limited to and consistent with fear reactions and consequent avoidance and hypervigilence. In contrast, Complex PTSD has been described as typically associated with chronic and repeated traumas and includes not only the symptoms of PTSD but also disturbances in self-organization reflected in emotion regulation, self-concept and relational difficulties (see Cloitre et al., 2013) a symptom profile that has been demonstrated as associated with prolonged trauma (Briere & Rickards, 2007).

Three studies have found evidence supporting the validity of the ICD-11 PTSD versus Complex PTSD distinction (see Table 1 for description of the diagnoses). Recently, in order to evaluate whether PTSD and Complex PTSD could be empirically distinguished from each other, Cloitre and colleagues (2013) performed a latent profile analysis (LPA) on assessment data from 302 treatment-seeking individuals with diverse trauma histories, ranging from single events (e.g., 9/11 attacks) to sustained exposures (e.g., childhood or adult physical and/or sexual abuse). The results were consistent with the ICD-11 formulation for Complex PTSD, with the best fitting LPA model delineating three classes of individuals: (1) a Complex PTSD class, with high levels of both PTSD symptoms as well as disturbances in self-organization related to affect regulation problems, negative self-concept, and relational difficulties; (2) a PTSD class, with high levels of PTSD symptoms but relatively low on the disturbances in self-organization that define Complex PTSD; and (3) a class relatively low on symptoms of both PTSD and Complex PTSD. Notably, these identified classes were identical when including an additional 86 participants with BPD, providing further support for the stability of the identified classes. Cloitre et al. (2013) also found that chronic trauma was more predictive of Complex PTSD than PTSD and that Complex PTSD resulted in significantly greater functional impairment than PTSD.